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Cover photo: Maria Theresa Oloando, an indigenous guide, leads me through the jungle to Siete Cascadas, a confluence of seven waterfalls in the remote north of Ecuador. I was there to report on eco-adventures in developing countries. You can read the story here.

Compass and Chain

Excerpt from a novel by Andrew Tolve

Mom was a nutritionist. A good one too. This fancy retreat center near Rutland paid her to lay out the meals for guests and lecture about diet, the virtues of veganism, how to eat local. One night on her way home she hit a deer in the rain. She called me and Daryl and we drove up there and broke the deer down and Mom’s car wasn’t even dinged up that bad, nothing that Daryl couldn’t fix.

A couple weeks later, though, Mom began complaining of soreness in her neck. Then in her shoulders. Then in her hips. Then she started seeing double of everything. It was almost funny at first, walking down the street hearing her ask, “Wait a second, does Tommy Knolls have a twin?!?” “Since when are there two stop signs on Main Street?”

One night making dinner she turned from the sink to the fridge to grab some lettuce and went sideways instead. Daryl caught her by the counter.

“I’m fine,” she said. “Really, everything is perfectly okay. I’ll be right back.”

I heard the bathroom door close behind her, the lid of the toilet click, a loud splash in the bowl.

“Let’s eat,” she said when she came back out.

Eventually it got so bad that she couldn’t drive, which meant that she couldn’t go to work, which meant that she had to go to the doctor whether she liked it or not. Mom was weird that way. My earliest memory of her was of her sitting on a chair in the backyard with a pair of tea bags over her eyes “baking out a migraine.” She hated pills, didn’t believe in vaccines, didn’t believe in processed foods either. It was like anything that society had touched was inherently tainted and untrustworthy. Hence the reason we lived in Suffern, a place where trees outnumbered people a zillion to four hundred and sixty-one.

Anyway, Mom went to see our local physician, Dr Logan, who was worried enough that he sent her to a specialist down in Brattleboro. Daryl and I went with her at her insistence. We were by her side in the waiting room, and the exam room, and were standing there as she got swallowed up in the MRI machine. They took her in so far that all we could see of her were the bottoms of her feet. Lots of rapid-fire clicking ensued, and jerking and jolting and thank god they let Mom wear headphones and an eye mask because when she came back out she had this placid smile on her face and said, “That was lovely actually. Was that Schubert or Brahms?”

We went out for lunch at a nearby diner that served the biggest root beer floats I had ever seen. You knew it was serious because Mom let me get one, plus french fries, and didn’t bat an eyelash when I started dunking my fries into the top of the float. She must have re-applied lipstick on the way from the office to the diner because I remember these bright magenta flashes firing off whenever she moved her lips and smiling back at them until the corner of my lips hurt I was forcing it so bad.

“It really is a beautiful day,” she said. “Look at the color of the trees.”

It was fall. The doctor’s face was glum when we got back to the office. I knew right then and there that it was cancer, I knew it before he said anything, my whole mind went numb and my eyes watered up so bad that now I was the one seeing like six of everything and Mom squeezed my hand and Daryl went white when the doctor pulled up the MRI images on the screen. “There is a tumor,” he said, “but it’s small, and it’s benign.”

“Benign?” Mom said.

I knew the word but the syllables sounded funny, all mashed up and muddled, the product of some alien dialect.

“In your pituitary gland,” he continued. “You see this small, white mass?” He pointed at the screen with a pencil. “It’s called a prolactinoma. It’s possible the trauma of the accident caused it. We see that sometimes, it can be inherited as well. Believe it or not, one out of ten to twelve adults in America has to deal with these things. They’re quite common.”

“In my nose?” Mom said.

“Well, it’s technically at the base of your brain. Right here,” the doctor said, and he pushed his finger above the bridge of his glasses. “It sits right below your optic chiasma, so the build up of pressure in your pituitary can impact your vision.”

“That’s why she’s been seeing double?” I asked.

The doctor nodded.

“And you mean that might not be, you know, permanent?”

The doctor smiled. “If she takes her medication, there’s a good chance it won’t be. Most patients I treat make a full recovery after twenty-four months.”

“About this medication,” Mom said.

“It’s a pill,” he said.

“I don’t do pills,” she said.

The doctor looked baffled. Then embarrassed, I suppose given the company.

“The other option is through, um, well vaginal injection.”

“I don’t do that either.”

“She can,” Daryl said.

“I won’t,” she said.

“You have to,” I said. “You don’t have a choice. You have to get better.”

I looked at her, and she looked at me, and we held each other’s gazes for a very long time. She turned back to the doctor.

“And if I don’t?” she asked.

The doctor frowned. “The greater the pressure on the optic nerve, the worse your vision. Infertility is a risk, hypothyroidism, if it goes long enough without treatment, cancer becomes a possibility.”

“We’ll take the drug,” Daryl said.

"And the side effects?” Mom said.

“In most cases, minimal,” the doctor said.

“I want to hear them,” she said.

“Nausea,” he said.

“And,” she said.

“Vomiting,” he said.

“And,” she said.

“Depression, dizziness, drowsiness.”

“Go on,” she said.

“Hot flashes, constipation, in some patients I see swelling of the ankles and wrists.”

“What about migraines?” she said.

“If there’s a prior history,” he said. “But again, none of these are certainties. And the upside is —”

“Thank you,” said Mom, “but no thank you,” and she stood and left the room with the doctor’s mouth so far open I could see the white of his tongue.

“Write the prescription,” Daryl said after she was gone. “She’ll take them, I promise.”

The ride home was silence. Mom stared out the window the whole way. Maybe she was blinking but I couldn’t see it, and I didn’t take my eyes off her once. She watched the mountains rise up and the farms roll by and there was a big tour bus parked on Suffern Main Street when we finally got back home. This was standard fair for leaf peeping season and usually I liked it, knowing that our little town attracted people from across the planet. But now all I saw were intruders everywhere — by the general store, on the porch of the library, all around the chapel, even in the cemetery where Pop Pop was buried — and there were lots of cameras out and peace signs pointing at the colors splashed across the mountains and I thought, They’re not for you. Not even close. Go away. I want the whole world to go away. We pulled into the driveway. Mom got out first and headed straight for her office. She closed the door behind her. It was original to the house, that door, even though at some point in the home’s two-hundred-year history someone had raised the door frame a foot to accommodate taller people. The result was a foot gap at the bottom. I stayed up late that night waiting for the light to go out. I got down on my knees every once in a while to peer inside. I could see Mom’s shadow on the floor but not her feet. Also, the legs of her desk and the bottom quarter of her bookshelves, which were racked from floor to ceiling with the bibles of nutrition, cooking, history. I heard pages turning, the crack of old bindings. At some point I lay down on the couch. It must have been five in the morning when the sky went gray and grainy against the window and I finally fell asleep.